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This is VAERS ID 25527

History of Changes from the VAERS Wayback Machine

Already in VAERS on 12/31/2003

VAERS ID: 25527
VAERS Form:
Age:5.2
Sex:Female
Location:Florida
Vaccinated:1990-03-01
Onset:1990-03-25
Submitted:0000-00-00
Entered:1990-07-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP / CONNAUGHT LABS 0J01114 / 4 - / -
OPV: ORIMUNE / LEDERLE 0596E / 3 - / -

Administered by: Private      Purchased by: Unknown
Symptoms: ENCEPHALITIS, NEURITIS OPTIC

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days:     Extended hospital stay? Yes
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: No family hx of seizure.Normal growth & development.NK drug allergies,milk allergy
Allergies:
Diagnostic Lab Data: Brain Scan & Biopsy, Lumbar Puncture
CDC 'Split Type':

Write-up: Pt admit to hosp w/encephalitis & optic neuritis on 25-MAR-90. Brain biopsy consistent w/post viral or post immunization. Viral titers pending 5th DTP no prior problems. No known drug allergies. Pt has milk allergy.


Changed on 12/8/2009

VAERS ID: 25527 Before After
VAERS Form:
Age:5.2
Sex:Female
Location:Florida
Vaccinated:1990-03-01
Onset:1990-03-25
Submitted:0000-00-00
Entered:1990-07-18 1990-07-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP DTP (NO BRAND NAME) / CONNAUGHT LABS CONNAUGHT LABORATORIES 0J01114 / 4 - / -
OPV: ORIMUNE POLIO VIRUS, ORAL (ORIMUNE) / LEDERLE LEDERLE LABORATORIES 0596E / 3 - / -

Administered by: Private      Purchased by: Unknown Private
Symptoms: Encephalitis, Optic neuritis, ENCEPHALITIS, NEURITIS OPTIC

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days:     Extended hospital stay? Yes
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: No family hx of seizure.Normal growth & development.NK drug allergies,milk allergy
Allergies:
Diagnostic Lab Data: Brain Scan & Biopsy, Lumbar Puncture
CDC 'Split Type': (blank) CO3525

Write-up: Pt admit to hosp w/encephalitis & optic neuritis on 25-MAR-90. Brain biopsy consistent w/post viral or post immunization. Viral titers pending 5th DTP no prior problems. No known drug allergies. Pt has milk allergy.


Changed on 2/14/2017

VAERS ID: 25527 Before After
VAERS Form:
Age:5.2 5.0
Sex:Female
Location:Florida
Vaccinated:1990-03-01
Onset:1990-03-25
Submitted:0000-00-00
Entered:1990-07-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (NO BRAND NAME) / CONNAUGHT LABORATORIES 0J01114 / 4 - / -
OPV: POLIO VIRUS, ORAL (ORIMUNE) / LEDERLE LABORATORIES 0596E / 3 - / -

Administered by: Private      Purchased by: Private
Symptoms: Encephalitis, Optic neuritis

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days:     Extended hospital stay? Yes
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: No family hx of seizure.Normal growth & development.NK drug allergies,milk allergy
Allergies:
Diagnostic Lab Data: Brain Scan & Biopsy, Lumbar Puncture
CDC 'Split Type': CO3525

Write-up: Pt admit to hosp w/encephalitis & optic neuritis on 25-MAR-90. Brain biopsy consistent w/post viral or post immunization. Viral titers pending 5th DTP no prior problems. No known drug allergies. Pt has milk allergy.


Changed on 5/14/2017

VAERS ID: 25527 Before After
VAERS Form:
Age:5.0
Sex:Female
Location:Florida
Vaccinated:1990-03-01
Onset:1990-03-25
Submitted:0000-00-00
Entered:1990-07-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (NO BRAND NAME) / CONNAUGHT LABORATORIES 0J01114 / 4 - / -
OPV: POLIO VIRUS, ORAL (ORIMUNE) / LEDERLE LABORATORIES PFIZER/WYETH 0596E / 3 - / -

Administered by: Private      Purchased by: Private
Symptoms: Encephalitis, Optic neuritis

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days:     Extended hospital stay? Yes
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions: No family hx of seizure.Normal growth & development.NK drug allergies,milk allergy
Allergies:
Diagnostic Lab Data: Brain Scan & Biopsy, Lumbar Puncture
CDC 'Split Type': CO3525

Write-up: Pt admit to hosp w/encephalitis & optic neuritis on 25-MAR-90. Brain biopsy consistent w/post viral or post immunization. Viral titers pending 5th DTP no prior problems. No known drug allergies. Pt has milk allergy.


Changed on 9/14/2017

VAERS ID: 25527 Before After
VAERS Form:(blank) 1
Age:5.0
Sex:Female
Location:Florida
Vaccinated:1990-03-01
Onset:1990-03-25
Submitted:0000-00-00
Entered:1990-07-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (NO BRAND NAME) / CONNAUGHT LABORATORIES 0J01114 / 4 5 - / -
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH 0596E / 3 4 - / -

Administered by: Private      Purchased by: Private
Symptoms: Encephalitis, Optic neuritis

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days:     Extended hospital stay? Yes
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions: No family hx of seizure.Normal growth & development.NK drug allergies,milk allergy
Allergies:
Diagnostic Lab Data: Brain Scan & Biopsy, Lumbar Puncture
CDC 'Split Type': CO3525

Write-up: Pt admit to hosp w/encephalitis & optic neuritis on 25-MAR-90. Brain biopsy consistent w/post viral or post immunization. Viral titers pending 5th DTP no prior problems. No known drug allergies. Pt has milk allergy.


Changed on 2/14/2018

VAERS ID: 25527 Before After
VAERS Form:1
Age:5.0
Sex:Female
Location:Florida
Vaccinated:1990-03-01
Onset:1990-03-25
Submitted:0000-00-00
Entered:1990-07-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (NO BRAND NAME) / CONNAUGHT LABORATORIES 0J01114 / 5 - / -
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH 0596E / 4 - / -

Administered by: Private      Purchased by: Private
Symptoms: Encephalitis, Optic neuritis

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days:     Extended hospital stay? Yes
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions: No family hx of seizure.Normal growth & development.NK drug allergies,milk allergy
Allergies:
Diagnostic Lab Data: Brain Scan & Biopsy, Lumbar Puncture
CDC 'Split Type': CO3525

Write-up: Pt admit to hosp w/encephalitis & optic neuritis on 25-MAR-90. Brain biopsy consistent w/post viral or post immunization. Viral titers pending 5th DTP no prior problems. No known drug allergies. Pt has milk allergy.


Changed on 6/14/2018

VAERS ID: 25527 Before After
VAERS Form:1
Age:5.0
Sex:Female
Location:Florida
Vaccinated:1990-03-01
Onset:1990-03-25
Submitted:0000-00-00
Entered:1990-07-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (NO BRAND NAME) / CONNAUGHT LABORATORIES 0J01114 / 5 - / -
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH 0596E / 4 - / -

Administered by: Private      Purchased by: Private
Symptoms: Encephalitis, Optic neuritis

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days:     Extended hospital stay? Yes
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions: No family hx of seizure.Normal growth & development.NK drug allergies,milk allergy
Allergies:
Diagnostic Lab Data: Brain Scan & Biopsy, Lumbar Puncture
CDC 'Split Type': CO3525

Write-up: Pt admit to hosp w/encephalitis & optic neuritis on 25-MAR-90. Brain biopsy consistent w/post viral or post immunization. Viral titers pending 5th DTP no prior problems. No known drug allergies. Pt has milk allergy.


Changed on 8/14/2018

VAERS ID: 25527 Before After
VAERS Form:1
Age:5.0
Sex:Female
Location:Florida
Vaccinated:1990-03-01
Onset:1990-03-25
Submitted:0000-00-00
Entered:1990-07-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (NO BRAND NAME) / CONNAUGHT LABORATORIES 0J01114 / 5 - / -
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH 0596E / 4 - / -

Administered by: Private      Purchased by: Private
Symptoms: Encephalitis, Optic neuritis

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days:     Extended hospital stay? Yes
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions: No family hx of seizure.Normal growth & development.NK drug allergies,milk allergy
Allergies:
Diagnostic Lab Data: Brain Scan & Biopsy, Lumbar Puncture
CDC 'Split Type': CO3525

Write-up: Pt admit to hosp w/encephalitis & optic neuritis on 25-MAR-90. Brain biopsy consistent w/post viral or post immunization. Viral titers pending 5th DTP no prior problems. No known drug allergies. Pt has milk allergy.


Changed on 9/14/2018

VAERS ID: 25527 Before After
VAERS Form:1
Age:5.0
Sex:Female
Location:Florida
Vaccinated:1990-03-01
Onset:1990-03-25
Submitted:0000-00-00
Entered:1990-07-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (NO BRAND NAME) / CONNAUGHT LABORATORIES 0J01114 / 5 - / -
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH 0596E / 4 - / -

Administered by: Private      Purchased by: Private
Symptoms: Encephalitis, Optic neuritis

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days:     Extended hospital stay? Yes
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions: No family hx of seizure.Normal growth & development.NK drug allergies,milk allergy
Allergies:
Diagnostic Lab Data: Brain Scan & Biopsy, Lumbar Puncture
CDC 'Split Type': CO3525

Write-up: Pt admit to hosp w/encephalitis & optic neuritis on 25-MAR-90. Brain biopsy consistent w/post viral or post immunization. Viral titers pending 5th DTP no prior problems. No known drug allergies. Pt has milk allergy.


Changed on 10/14/2018

VAERS ID: 25527 Before After
VAERS Form:1
Age:5.0
Sex:Female
Location:Florida
Vaccinated:1990-03-01
Onset:1990-03-25
Submitted:0000-00-00
Entered:1990-07-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (NO BRAND NAME) / CONNAUGHT LABORATORIES 0J01114 / 5 - / -
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH 0596E / 4 - / -

Administered by: Private      Purchased by: Private
Symptoms: Encephalitis, Optic neuritis

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days:     Extended hospital stay? Yes
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions: No family hx of seizure.Normal growth & development.NK drug allergies,milk allergy
Allergies:
Diagnostic Lab Data: Brain Scan & Biopsy, Lumbar Puncture
CDC 'Split Type': CO3525

Write-up: Pt admit to hosp w/encephalitis & optic neuritis on 25-MAR-90. Brain biopsy consistent w/post viral or post immunization. Viral titers pending 5th DTP no prior problems. No known drug allergies. Pt has milk allergy.


Changed on 12/24/2020

VAERS ID: 25527 Before After
VAERS Form:1
Age:5.0
Sex:Female
Location:Florida
Vaccinated:1990-03-01
Onset:1990-03-25
Submitted:0000-00-00
Entered:1990-07-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (NO BRAND NAME) / CONNAUGHT LABORATORIES 0J01114 / 5 - / -
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH 0596E / 4 - / -

Administered by: Private      Purchased by: Private
Symptoms: Encephalitis, Optic neuritis

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days:     Extended hospital stay? Yes
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions: No family hx of seizure.Normal growth & development.NK drug allergies,milk allergy
Allergies:
Diagnostic Lab Data: Brain Scan & Biopsy, Lumbar Puncture
CDC 'Split Type': CO3525

Write-up: Pt admit to hosp w/encephalitis & optic neuritis on 25-MAR-90. Brain biopsy consistent w/post viral or post immunization. Viral titers pending 5th DTP no prior problems. No known drug allergies. Pt has milk allergy.


Changed on 12/30/2020

VAERS ID: 25527 Before After
VAERS Form:1
Age:5.0
Sex:Female
Location:Florida
Vaccinated:1990-03-01
Onset:1990-03-25
Submitted:0000-00-00
Entered:1990-07-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (NO BRAND NAME) / CONNAUGHT LABORATORIES 0J01114 / 5 - / -
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH 0596E / 4 - / -

Administered by: Private      Purchased by: Private
Symptoms: Encephalitis, Optic neuritis

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days:     Extended hospital stay? Yes
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions: No family hx of seizure.Normal growth & development.NK drug allergies,milk allergy
Allergies:
Diagnostic Lab Data: Brain Scan & Biopsy, Lumbar Puncture
CDC 'Split Type': CO3525

Write-up: Pt admit to hosp w/encephalitis & optic neuritis on 25-MAR-90. Brain biopsy consistent w/post viral or post immunization. Viral titers pending 5th DTP no prior problems. No known drug allergies. Pt has milk allergy.

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